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Cannabis-Induced Problems?

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

Q. Adjustment issues, anxiety, Cannibus induced? I am a Freshman in college, just now finishing up my first year. In high school, I ran XC and track, and was an occasional pot smoker. Also, I was a popular kid, and got decent grades. However, since I’ve graduated high school, I rarely run, and smoke more pot than I ever have (about 2-3 times a week when school is in session, and almost everyday during my breaks), but still manage to maintain my grades. The summer after graduation, I started to develop anxiety and absurd, negative thoughts. For example, I started having this idea that there was some “social” cosmos, and that every action someone made, was a part of this “plan.” While smoking, I experienced some panic attacks and a vicious cycle of negative thoughts, some of which were violent. Also, after an attack, I have a self-accusation that I’m gay. However in the past, I’ve never had such thoughts of homosexuality. I have had a good history with women, and am currently seeing a girl back home. These thoughts seem to have come out of nowhere. Also, they have caused major stress, to the point where it becomes difficult to socialize, even with my best friends. I’ve felt strong feelings of insecurities and some loss of self-worth, and constantly compare myself to my father and my brother. I’ve always been a happy, out-going person, but now I feel like I’m incapable of being either.

I had been attack-free for about 3 months, however, recently I “celebrated” 4/20 by being high all day. I had one attack that day. My symptoms are the worst they’ve ever been. The most scary part is I don’t know what to believe. I don’t know if these thoughts are a product of my shift to college. Or is it the fact that I live a less healthy lifestyle, all intensified by the increase of marijuana use. Please, a little insight from a professional view is all I need to get an idea of what I need change in my life.

You only used to smoke marijuana occasionally. Then you went to college and your marijuana use increased significantly. After your marijuana use increased you stopped doing most of the activities you enjoyed. Then panic attacks started. Not only have you begun to have panic attacks, seemingly related to your use of marijuana, it also seems that you’ve developed paranoid thoughts. You’ve also developed insecurities that you didn’t used to have. You seem to be experiencing depression and an overall decrease in your psychological well-being. All this has caused you a great deal of stress.

If we look at this analytically and objectively we’d see a correlation between your increased use of marijuana and a significant decrease in your quality of life. You were an energetic teenager, who engaged in many social activities, who had a good sense of self-worth and who seemed to be relatively happy. Then you started using drugs and your life started falling apart. I hope you can see the connection between your drug use and your negative symptoms.

I cannot answer the specific question of whether the issues you are experiencing are related to stress from attending college or your use of drugs. It seems that you had some stress associated with going to college, then you started to use drugs and everything went downhill from there. I hope you can see that your use of drugs has not helped you in any way and it has significantly hurt you.

I know people believe that marijuana is not that bad of a drug. Many people think it’s a relatively safe drug to use. I’ve known many people who psychologically separated in their minds marijuana from other drugs such as cocaine, PCP etc. For them marijuana is as innocent as smoking a cigarette. The fact is that marijuana is a hallucinogenic drug. LSD is also a hallucinogenic drug. These are very serious drugs. Both of these drugs have been associated with the development of severe mental illness. There is no one known cause of severe mental illness but it’s important to note that marijuana has been linked to illnesses such as schizophrenia and bipolar disorder. My point in bringing this information to your attention is that by using marijuana you’re not only decreasing your quality of life but you’re essentially “playing with fire.” Marijuana can permanently alter your brain chemistry in a negative way.

I would strongly encourage you to stop using marijuana. As you mentioned in your letter the last time you used marijuana to celebrate “420” day you had a panic attack. This should be enough to tell you to stop. Your body and your brain are rejecting these drugs. It’s possible that if you never used marijuana or any other drugs again, that you may not ever have a another panic attack. Your quality of life almost certainly will improve as well.

You also mentioned that you stopped engaging in athletic activities. People who smoke marijuana often lack motivation and energy. That’s one of the side effects of the drug. Perhaps if you stopped smoking marijuana you’d have the energy to return to the activities you once enjoyed. Engaging in these activities will probably also improve your quality of life.

For your own mental health and well-being it is advisable that you stop using marijuana. The concern is that your mental health symptoms will continue or intensify. If you need help and are not sure how to stop then you should consider making an appointment at the counseling center at your college. If you stop using marijuana and get help, if you need it, then your sophomore year will be much better than your freshman year.

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Personality Disorder? What’s Wrong with Me?

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

I’m feel like there is something seriously wrong with my head and I just don’t know what it is? I’ve researched a lot of different mental disorders and I can relate to a lot of the symptoms of so many of them. When I was in 4th grade I was diagnosed with ADD and I’ve have had on and off depression, disordered eating habits, and anxiety since then but I was diagnosed with depression and anxiety 3 months ago. Lately I have been feeling very disconnected and can’t stop zoning out, when I’m not zoned out my vision is distorted. Everything looks like its shifting, breathing, certain things pop out a lot, and when I read text it waves and spirals into itself. Sometimes when I walk I feel the curve of the earth and everything to the side of me looks downhill. Kind of like tripping but not. I did do LSD twice about 5 months ago but I’ve only been experiencing these symptoms for 2 or 3 months so it’s not because of the acid. I question reality and get confused about the concept of time and sometimes I completely forget who I am. Also been having bad insomnia and strange sleep patterns. I’ve been impulsive and doing things that I regret later; smoking a lot more than usual, drinking all the time and trying other harder drugs like Xanax and coke(once) but thats weird for me because I’ve always thought of myself as weed only. I’ve also been hooking up with a lot more guys which is weird for me because I’ve always been kind of afraid of and have never been in a relationship and am very self conscious but I keep hooking up with guys I don’t care about. I also just really hate my personality. I try to seem unique but really I have no personality, I’ m nothing but a bunch of stolen identities. When I ask someone to hang out and they can’t I get extremely hurt by that to the point of tears and think that everyone thinks I’m annoying and that girl that I think is cool and I wish people could see me the same way as people see her knows that I’m copying her. Sometimes I’m afraid to go on the deck because I think I can’t control myself and I might jump off.

It’s not possible to determine a diagnosis over the Internet. The other issue is your age. Some mental health professionals are reluctant to diagnose teenagers with a mental illness because it is a turbulent time, both developmentally and emotionally.

When mental health problems are a concern, it is especially important to refrain from using drugs and alcohol. They can negatively impact your mood and personality. They could make your symptoms worse or perhaps may even be causing them. Therefore it would be in your best interest to stop using drugs and alcohol.

It was your opinion that you don’t possess a “unique personality ” and that you are a conglomeration of a “bunch of stolen identities.” What I think you might mean is that you are behaving in ways that you believe other people want you to instead of just being yourself. That could stem from low self-esteem.

Lack of self-esteem might also be evidenced by your “hooking up with guys [you] don’t care about.” You might not be so willing to indiscriminately “hook up” with these people if you felt better about yourself.

You have received different diagnoses. This would suggest that you have been evaluated by a mental health clinician. It’s good that you were in contact with mental health professionals, but you did not mention being in treatment. Counseling is the ideal treatment for the problems you have described. Medication could also help with your symptoms.

Erik Erikson is a famous and well-accepted developmental theorist. He talks about a stage that people go through when growing up. It is called identity vs. identity confusion. In essence he is saying that a teenager must go through a stage where they will find out who they are. They need to find their identity. You can read about this and see if it explains some of your feelings.

The symptoms you described require treatment. Contact a mental health professional and ask for his or her assistance. What’s most important is treating your symptoms with counseling and if necessary, medication. Please take care.

Dr. Kristina Randle

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Insomnia & Substance Abuse

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP
written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

For the past two months, I’ve been plagued by insomnia (or what I believe to be insomnia; not diagnosed) every waking second I’m breathing on this earth. And this is really bad. I’m only sleeping two hours a day, maybe sometimes three, and then crashing on the sixth or seventh day sleeping around eight hours.

I’ve also been abusing a lot of cocaine, LSD and oxycodone lately – just because I’m bored, really bored. To be fair, I only do cocaine maybe twice a week, and oxycodone just a few times as it helped me fall asleep some times, but it doesn’t seem to work anymore.

I do cocaine to be social at school. When high on it, I’m talking for hours about anything to anyone. It makes me people wanna be around me. It’s wonderful. It’s pure bliss. And as described above, I only did oxycodone a few times as a sleeping agent.

With LSD, I’ve done maybe 8,000 micrograms of it, meaning I’ve done about 80 hits. This was the over the span of three months, I believe. I stopped taking it as it begun to become a boring thing to do. I’ve currently had a vested interest in amphetamines like adderall as it lasts longer than cocaine.

And, I personally believe if I could fix this dreadful fucking insomnia that I won’t need to abuse drugs. When I’ve slept for 8 hours, I’m completely different. I’m social, open and happy. When deprived of sleep, I can’t concentrate at all (I quite literally lose focus in basic conversations), I hate everything, and so forth.

I can’t go to the doctors because my mom thinks I’m just lazy and thinks I’m using my sleep deprivation as an excuse. I’ve gotten sleeping medication like Ambien illegally, it worked for a few days, then didn’t. Essentially… nothing works. Exercising doesn’t work. I have a tight schedule. I eat healthy, drink lots of water. But lo and behold, I still want to kill myself from the sleep deprivation every single waking hour on this planet.

Please help. I want motivation. I want true, and not artificial happiness with tools like cocaine. I want to be able to socialize naturally, not whilst on cocaine. I’m simply just empty and angry – not depressed, sad or hopeless mind you.

Anyways… what do I do? (From Norway)

You’ve done the right thing by reaching out here. Thank you for your bravery in dealing with this head on. What I get from your email is that you are in a cycle that feeds on itself. The drugs you are using to deal with the boredom have made you so anxious you need different drugs to make you sleep, which triggers the boredom — and it begins again. This type of cycle keeps pulling you down — making the drugs ineffective because you’ll need more of everything. This typically doesn’t end well — so your desire to deal with it now is crucial.

First thing’s first. Get some help for getting off the drugs. You’ve got to do that first to break the cycle. I’d find a Narcotics Anonymous (NA) meeting nearby you and begin attending. You won’t be able to think clearly and create a plan until you have taken care of this. The insomnia is now related to the cycle of drug use. The link will also help you find resources to help you with that.

Dr. Dan

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Derealization/Depersonalization & Fear of Psychosis or Schizophrenia After LSD-Induced Panic Attack

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

I swallowed a tiny microdose of LSD (around 25 micrograms, not nearly enough for an actual trip) five days ago and experienced a panic attack because I feared I may have gained schizophrenia or some sort of psychosis from the LSD for no reason other than perhaps I was overthinking too much.

Over the next two days, I felt somewhat uneasy and suspicious over whether or not I had psychosis and then I later experienced panic attack in my sleep over the possibility of developing a psychosis. This panic attack gave me the sensation of derealization/depersonalization because I became so suspicious over the possibility of experiencing hallucinations and/or delusions and diving into a psychotic break from reality. Over a period of the day, I was momentarily afraid of certain photographs and small surprises because I feared a psychotic break from reality. I checked with my parents and siblings and they didn’t notice anything wrong with me aside from my trembling head.

Today, I am now no longer experiencing anxiety/panic attacks after getting some rest and taking some herbal supplements. However, despite this state of calmness, I still have intermittent derealization/depersonalization and I still have the lingering sensation that something is not right with my mind and I could experience a psychotic break from reality at any moment. I am also noticing that I strangely feel energized/well-rested after only 3-5 hours of sleep. I would like to know the chances that I am actually entering a psychotic/schizophrenic state.

There’s no way to know with certainty the chances of you having a psychotic break or developing schizophrenia. That is one of the risks that one takes in the use of LSD and other illicit drugs. The adverse effects are very subjective, extreme and unpredictable. That is, in part, what makes them so dangerous. One individual may experience a positive effect and have no lasting aftereffects whereas another individual could have the totally opposite experience and develop severe anxiety, panic, depersonalization/depersonalization, and so forth. An individual might have a good trip on one occasion and a bad trip on the next.

In studies, the biggest concern related to LSD is often the dangerous and erratic behavior that results from the experiences with the drug. Studies have indicated that there are some possible health side effects that can occur with LSD including extreme changes in body temperature, sweating, chills, loss of appetite, sleeplessness, dry mouth, tremors, among others. Most commonly, however, are what is referred to as LSD intoxication or psychosis. Some of the mental effects of LSD can include:

  • Delusions (believing in things that are not true, despite evidence to the contrary)
  • Hallucinations (typically visual)
  • distorted sense of time and identity
  • impaired depth and time perception
  • artificial euphoria uncertainty
  • distorted perception of objects, movements, colors, sounds and touch
  • severe terrifying thoughts and feelings
  • feelings of losing control
  • fear of death
  • panic attacks

Research also indicates that there are no medical benefits associated with LSD. It can cause a great deal of potential problems including psychosis among others, and should be avoided.

It’s not clear why you took the drug in the first place but you should never take it again. This is especially true because of the negative experiences you had. It seems as though you’ve had a bad trip and it would be ill advised to take the drug again, and to risk repeating this experience. Thankfully, though you are continuing experience mild symptoms, they seem to be diminishing. Hopefully, they will be gone forever and will no longer cause you any problems.

You also mentioned taking herbal supplements. It’s important to know that they are not typically regulated by the federal government (i.e. Federal drug administration (FDA), and thus their effects are unknown. I would recommend consulting a psychiatrist who can advise you about how to treat the remaining symptoms you are experiencing. You should not be attempting to manage your own symptoms especially given your paranoid state of mind. It’s always best to consult experts rather than attempting to treat yourself. You can’t get into trouble with health care providers for having used LSD. They are not going to turn you into the police. They can help you to feel better sooner, which is ultimately your goal. Good luck and please take care.

Dr. Kristina Randle

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Help with LSD Abuse

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

The only time I feel any happiness is when I’m on LSD, and the next three days after a ‘trip’. It’s the only time I feel as I have any feelings…in general. I’ve been this pretty much ever since I can remember, way before I even began taking LSD. Doing LSD is pretty much the only good choice I’ve ever made. I believe I started a few months after I turned 14.

Regarding my real life, I attempt to act as normal as I possibly can. I have “friends”, even though I much more prefer being isolated in my room, and preferably doing acid. And I get along with my parents, they have no idea I’m doing LSD. The only slight worry they have is how I isolate myself. It’s pretty much routine, wake up, go to school, go home, in room all day, sleep. They don’t mind it so much, but I can tell they’d much more prefer me hanging out with “my buds” or something.

Other then that, I’ve been arrested two times on accounts of computer abuse or something. It’s complicated, but I can sum it up by: I caused the community approximately $280,000 in damages. Either way, I was never charged, since, “Plausible Deniability”, and my parents are firm believers of my story. The second time was some made-up story about extortion on homosexuals, I believe they did so for revenge for not catching me on the other charge. To be honest, I’m very glad I hurt them. I know they don’t deserve it, but, I just need some way to relieve myself of my frustrations. It’s pretty pathetic, but very funny and amusing – I’m pretty sure the attack caused quite the halt of progress for a few months.

Back to my reason for asking here: I really want a way out of loneliness. I don’t really feel any pain with my loneliness, but, I really hate knowing that I’m wasting time on senseless Netflix shows when I could (probably) be doing something productive. And the thing that’s pissing me off the most is I have no idea why I despise school, authority, rules, etc; pretty much everything besides acid, my computer, and sleep.

Here’s some other notes about myself to really prove I’m a shining star of society; I’m incredibly lazy, and I would rather have curable cancer then going to school.

It is not a surprise that you feel good when you are high on drugs; that is what they are designed to do. It is one of the main reasons why people use them. They make you feel good but they can ruin your life. Many lives have been destroyed by drug use.

LSD is particularly dangerous. It is a potent drug that has been linked to psychotic disorders. Make no mistake about it, you’re risking your mental health each time you use a drug.

Your drug use has already negatively impacted your life. You have not been officially charged with a crime but you’ve been close. Your luck could change.

You said that you despise school. So do many teenagers, but they still go to school. You’d be hard-pressed to find many teenagers who, if given the choice, would go to school voluntarily. There are many disadvantages to not finishing your basic education. Like drug use, not finishing school will be detrimental to your life.

I strongly urge you to seek counseling and to stop doing drugs. If your drug use continues, you risk getting into trouble and developing mental health problems. A mental health professional can treat the problems you have written about and facilitate your development of important problem solving skills. Please take care.

Dr. Kristina Randle

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When Does Schizophrenia Show Up in Women?

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

Both of my parents are mentally ill, my mother suffering from Schizophrenia and my father from Manic Depression. Both of my parents had regular auditory hallucinations and paranoia.

At 21, I’ve yet to suffer from any of their symptoms, but have been struggling with PTSD and related anxiety. Since I was aware enough to know my parents were ill, I’ve constantly monitored myself to make sure I wasn’t sick like they were.

From reading on this site and others, it appears that Schizophrenia shows up in women later than men. Could someone please talk about this more? Since I’m a 21 year old woman, I’d like to know if it’s possible for me to still develop Schizophrenia (though I show no signs of it now and haven’t in the past). I also just want to know at what age can I finally relax and know I’m past the threshold.

You are correct. Schizophrenia does tend to occur later in women than in males. The average age range for a female to develop schizophrenia is roughly ages 25-29 (18-21 in males). The reasons for the age difference between genders are not well understood.

Not every male or female who ultimately develops schizophrenia does so within the above-mentioned age range averages. Males can develop schizophrenia later than late- adolescence and females may get it sooner than their late twenties.

But you must know that just because both of your parents had a mental illness in no way means that you will be mentally ill. One does not necessarily lead to the other. It is true that people whose parents have a mental illness are at a greater risk for the development of a mental illness. Heredity does seem to play a role but there are many more factors that contribute to the development of a psychiatric illness.

The environment an individual grows up in can affect whether or a not a disorder develops. The majority of people with schizophrenia, for instance, report childhood physical, sexual or mental abuse. This is not to say that all people who are abused go on to develop schizophrenia. This is clearly not the case. But in some instances, the abuse could have possibly contributed to the development of the disease. Maybe if these individuals had never been exposed to abuse they may not have developed schizophrenia.

Drug use can also play a role in the development of schizophrenia. Drug use is commonly associated with schizophrenia, as well as bipolar disorder. I am familiar with a case in which a “normal” young adult male spent his weekend using LSD. By the end of the weekend, his LSD “high” never wore off. He never returned to his “normal” state of mind and subsequently suffered many psychotic breaks and was later diagnosed with schizophrenia. No one can be sure that his drug use definitely led to schizophrenia but it is a distinct possibility.

You are not doomed to develop the disease just because your parents did. You mentioned you have some other psychiatric issues, such anxiety and PTSD but neither of these are signs of schizophrenia. You also mentioned you have no other symptoms that would lead you to believe that you have the disorder. Please know that realistically, your chances of developing schizophrenia are very slim.

It’s unhealthy for you to constantly worry about this issue. By constantly focusing on this fear, you are keeping it alive and helping it to grow. If you do continually worry about this, it would be helpful for you to contact a therapist. You may feel better if you had someone you can discuss these fears with. A therapist can also help you with your anxiety issues as well as the PTSD. I hope this helps.

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Does My Brother Have Paranoia or Schizophrenia?

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

Hi – I’m new here, but don’t where else to go. This is in regard to my sibling.

He is 37 and lives with my mother in Florida. He has a severe problem with marijuana and has a history of substance abuse (cocaine, LSD, psilocybin, MDMA/MDA, alcohol). He currently has no job, isn’t looking, and no other prospects. He had a job recently, but was terminated. Also, very negative and seems to self-sabotage any job he may find. Seemed to find a conspiracy at work.

Additionally, he has developed an intense and chronic obsession with conspiracy theories (New World Order, Illuminati, MK Ultra programming, 9/11, fallen angels, aliens, psilocybin just to name a few). He already hurt himself where the EMS had to intervene (non-life threatening). Every conversation revolves around one aspect of a conspiracy whether its music, movies, governments, politics, etc. He believes the United States will collapse due to a well orchestrated plan by the “shadow” government.

He has driven friends away and doing well to drive family away.

He spends his time online posting “articles” and information regarding the “truth” about government, or the “truth” about the music industry. He also told me he believed aliens came in the house and unplugged some electronics connected to the TV. He also believes there are aliens flying around the housing complex at night (even though they are obviously planes, we live near several airports). Believes they “hover” over the house on a nightly basis.

He over reacts, sometimes aggressively, to the slightest criticism, whether it be about appearance, performance, ect. Believes marijuana is some miracle drug and simply won’t listen to ANY criticism or reason. He refuses any advice or input from anyone, regardless (for example he contacted the Mutual UFO network to “report” his sightings. A retired military person paid a visit and confirmed planes in the area) of whom they may be.

I realize this is a lot, but I’m worried and have been worried for years. I don’t know if I can help, or if there is help?

Generally speaking, the only time you can force an individual into treatment is when he or she poses an imminent danger to themselves or to others. In that circumstance, an individual could be committed to a mental hospital, typically for a short period of time (about one week but each case is variable). Once they no longer pose an imminent threat, they are released from the hospital with a recommended treatment plan. Typically, people can choose to follow the recommended treatment plan or not. If they don’t comply, there is no “penalty.”

Your mother may be in the best position to leverage him into treatment. She allows him to live with her despite him not being in treatment. If she no longer allowed that, then he may be forced to seek help. That might be the only way to convince him to participate in treatment.

Short of your mother attempting to leverage him into treatment, there is probably little else that can be done. As long as she allows him to live in her home, behaving the way he does, then he has no reason to change.

Depending upon how involved you are with your brother’s care, you may be able to assist your mother. Involve other members of the family if you think it would help.

Whether or not he has schizophrenia could only be determined by an in-person, mental health evaluation. He displays paranoid tendencies but it is difficult to know if it is due to his drug use or a mental illness.

For additional assistance, contact the National Alliance on Mental Illness (NAMI). NAMI is an advocacy group that assists people in navigating the mental health system. They may be able to provide you with additional ideas and resources for your family. Please take care.

Dr. Kristina Randle

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PTSD caused by drug use?

by Dr. Marie Hartwell-Walker
written by Dr. Marie Hartwell-Walker

About a year ago to the month, I was in the midst of a very painful break-up during my senior year of college. I had been with my ex for 2 years, it was a very serious relationship, we lived together, and the split was entirely unexpected. In retrospect, the relationship was unhealthy… I changed/compromised myself a lot to try and appease my ex, to fit into his life, and I think I convinced myself that I was happy regardless.

I began a close relationship with two friends (men) that were into drug experimentation. I was already a habitual marijuana smoker, but kicked it up to a gross level (at least 1 gram a day, every day, whether alone or in company). I then began experimenting with mushrooms, LSD, and, finally, MDMA. The first and only time I took MDMA, I believe I took a toxic dose over the course of 24 hours (.7 grams of pure, powder form, ingested). I experienced no major adverse reaction while intoxicated, but at the “crash” I lost my mind. Severe anxiety, paranoia, depression, uncontrollable crying, inability to be still, major depersonalization and hysteria. It was an enormous amount of emotion and mania all at once, immediately as soon as I woke up. A contributing factor was finding out in the midst of my “roll” that my ex had a new girlfriend (we had been broken up about 6 weeks), a fact that seemed to precipitate into a flood of emotions tied up in our break up (why doesn’t he feel as bad as I do? does he love me anymore? I miss him, I want to talk to him, etc).

My whirlwind of emotions was so acute I felt unsafe leaving my apartment for several days. By about the 6th day the hysteria had receded and had been replaced with intense depersonalization and no sense of reality. I was scouring the internet for a solution or diagnosis for my feelings when I came upon the term “depersonalization” and immediately dissolved into a serious depression once I had a name for what I was experiencing. By the 12th day since the “crash,” I began to feel normal, if not shaken.

About three weeks after this experience, I took a dose of mushrooms. The trip went badly. My experience was being caught in a feedback loop of negative feelings, that I would never feel any differently ever again, that I had no control over my own sanity. Eventually I became physically ill, and the mushrooms wore off. I had no “crash” effects.

I decided to stop taking psychedelic drugs after that, but continued to drink and smoke heavily. About 6 weeks after crashing on MDMA, I experienced the most intense anxiety attack of my life. One of my aforementioned friends and I were about to visit our third friend’s going-away party (he was moving out of state). Previous to this, I had absolutely no history or experience with anxiety, and actually did not know I was even having an anxiety attack until later. The feelings of anxiety and sporadic full-blown panic attacks lasted for 4 days. At that point, I stopped smoking and drinking completely, and began attending counseling via the student center.

While I finally addressed and acknowledged many issues with my break up and drug use during counseling, my general emotional/psychological health was shaky at best. There was a lot of fallout after my anxiety episode and the drug side effects. I barely made it through graduation without a complete meltdown, and only with the support of my father and a few close, sober friends.

Today, I have changed my life and am 100% a different, healthier person. My old relationship and my ex are not present in my life. I run, I practice yoga, I’m a vegetarian, I lost 15lbs. I drink socially, but have not smoked or taken any other drugs since. I am even suspicious of things like codine cough syrup or Sudafed due to their drug content. However, once in a while, something reminds me of my drug experiences or the aftermath, and I immediately feel frozen – taken back to those feelings and experiences in an overwhelmingly negative way – and have to fight off anxiety attacks. This especially happens when coming into contact with marijuana or viewing drug use in movies. Sometimes nothing triggers it, but suddenly I am consumed with the memory of something that happened during that time, and all the emotions associated with it.

I feel like my drug abuse will haunt me forever. Once in a great while, I have sudden urges to smoke marijuana or take MDMA, for no apparent reason. I have also begun dating after being single for more than a year, and sometimes experience borderline panic attacks out of nowhere in the middle of a date. I have spent the night with a guy or two a few times, and cannot sleep while someone is in the same bed as me. My heart pounds, I feel nervous, sweaty palms, and cannot relax.

When I took the Sanity Quiz on this site it says that I exhibit symptoms of PTSD, which led me to write this tome (sorry!) and ask about it. Am I experiencing PTSD as a result of my drug abuse? Will these flashbacks ever go away? I know I should probably be in regular therapy, but I can’t afford it.

Thank you for writing. It must be discouraging to find that you are still having symptoms of anxiety after working so hard to get clean and sober. PTSD is a subset of the anxiety disorders. I don’t know enough about you to determine whether you meet the criteria for that diagnosis. It certainly sounds as if you are having what are called “flashbacks” to your bad experience with drugs. Flashbacks are the involuntary reliving of a bad drug experience days, weeks or even months after a “trip.” They usually follow some auditory or visual cue that triggers a memory of the experience. Flashbacks feel very, very real.

You did the very important first chapter of your therapy. It’s to your credit that you finally realized that you were endangering your life and that you were motivated enough to do something about it by getting involved in some counseling and by reaching out for some help from your father and friends. Good for you! You followed up with major changes in your lifestyle. Also good.

Now you need to go to the next level. You need to learn some new coping skills both to handle the flashbacks and to manage the intense feelings that go with taking another risk at intimacy. All this is to say that you’re right: You do need to get back into some kind of therapy.

Before you decide you can’t afford it, talk to your doctor about whether there is a local clinic or therapists in private practice who offer a sliding fee scale. You might also be able to arrange a payment plan with someone. If you really can’t find a way to pay for some therapy, do some reading up on how to increase your sense of resiliency. Continue the healthy lifestyle you’ve established. Spend time developing your friendships and support system. If the flashbacks happen again, remind yourself that they are only memories and that they will go away. (Yoga practice should help.) And do ask your doctor if there is anything more you can do to counteract them.

Although a year may feel to you like a long time, from my point of view you’ve accomplished a great deal in a short time. You’ve done a wonderful job taking charge of your life to make it better. Please be patient with yourself. Go slow with the relationship. Honor your own feelings. And continue on the path you’ve started. You’ll get there.

I wish you well.
Dr. Marie

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